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Tumor stiffness and stiffness change using 3D MR elastography are markers of tumor lymphocyte infiltration and immunotherapy response in HCC.

Paul Kennedy¹, Muhammed Shareef¹, Octavia Bane¹, Guillermo Carbonell¹, Elizabeth Miller², Israel Lowy², Stephen Ward¹, M. Isabel Fiel¹, Miriam Merad¹, Thomas Marron¹, and Bachir Taouli¹
¹Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Regeneron Pharmaceuticals Inc., Tarrytown, NY, United States

Tumor stiffness measured with 3D MRE correlates with grade of tumor infiltrating lymphocytes, and tumor stiffness changes are associated with degree of tumor necrosis following immunotherapy.

Figure 1: Example pre- and post-immunotherapy images from an 83 yr old female with hepatitis B. A 7cm hepatocellular carcinoma is seen in the right lobe (white outline). A moderate decrease in tumor stiffness (TS) is noted post immunotherapy however liver stiffness (LS) remains unchanged. At resection the tumor was 100% necrotic.

Figure 2: Boxplot showing elevated baseline stiffness in tumors with high density of tumor infiltrating lymphocytes at resection.